<br /><div>
<form id="rep_period_frm" method="post" action="?p={page}">
<b>{date_choice}:</b>
<b>{date_from}</b><input id="date_from" name="date_from" type="text" class="tcal" value="{date_from_v}" /> 
<b>{date_to}</b><input id="date_to" name="date_to" type="text" class="tcal" value="{date_to_v}" />
<table border="1">
<tr><th>{employeess}</th><td><select id="employee1" name="employee1" onchange="repEmpChange(1);"><option selected="selected"></option>{employee_opt1}</select><select id="employee2" name="employee2" onchange="repEmpChange();"><option selected="selected"></option>{employee_opt2}</select></td></tr>
<tr><th>{brokerss}</th><td><select id="broker1" name="broker1" onchange="repBrokChange(1);"><option selected="selected"></option>{broker_opt1}</select><select id="broker2" name="broker2" onchange="repBrokChange();"><option selected="selected"></option>{broker_opt2}</select></td></tr>
<tr><th>{ins_takers}</th><td><select id="ins_takers" name="ins_takers" onchange="repTakersChange()"><option selected="selected"></option>{ins_takers_opt}</select></td></tr>
<tr><th>{ins_comps}</th><td><select id="ins_comps" name="ins_comps" onchange="repCompChange()"><option selected="selected"></option>{ins_comps_opt}</select></td></tr>
</table>
<hr />
<table border="1">
<tr><td><input name="report_type" type="radio" value="ins_contracts" title="{ins_contracts}" {ins_contracts_s} /></td><td>{ins_contracts}</td></tr>
<tr><td><input name="report_type" type="radio" value="payments" title="{payments}" {payments_s} /></td><td>{payments}</td></tr>
<tr><td><input name="report_type" type="radio" value="rpayments" title="{rpayments}" {rpayments_s} /></td><td>{rpayments}</td></tr>
<tr><td><input name="report_type" type="radio" value="pol_restore" title="{pol_restore}" {pol_restore_s} /></td><td>{pol_restore}</td></tr>
<tr><td><input name="report_type" type="radio" value="pol_payable" title="{pol_payable}" {pol_payable_s} /></td><td>{pol_payable}</td></tr>
<tr><td><input name="report_type" type="radio" value="pol_canceled" title="{pol_canceled}" {pol_canceled_s} /></td><td>{pol_canceled}</td></tr>
</table>
<input onclick="report('rep_period_frm')" type="button" class="yt_button" value="{report}" />
</form>
</div><hr />